Friday 25 May 2018

Ask the doctor: The horror stories about Lyme disease frighten me. How can I protect my family from it this summer?

Dr Jennifer Grant, a GP with the Beacon HealthCheck screening programme at Beacon Hospital
Dr Jennifer Grant, a GP with the Beacon HealthCheck screening programme at Beacon Hospital

Got a medical question or need health advice? Dr Jennifer Grant has the answers.

I've been reading a lot about ticks and Lyme disease during the summer time and hoping for some advice on how to best protect my children? We just moved to the country side so it's very difficult to keep them out of long grassy areas. The horror stories I've read are frightening me into thinking, what if I miss one!

Dr Jennifer's reply: I understand your fear as we all feel we could miss something big in ourselves or our children. Lyme disease is bacterial illness transmitted by the bite of an infected tick. It is relatively uncommon in Ireland, but you would be wise to bear it in mind when visiting areas with deep or overgrown vegetation in woodland or heath areas, even gardens or parks as the ticks congregate where they have access to birds, mammals (deer, sheep, cattle and goat) even humans to feed on.

Ticks don't jump or fly, but climb on to your clothes or skin if you brush against them. They then bite into the skin and start to feed on your blood, often remaining attached for more than 24 hours.

It's advisable to remove one properly with a tweezers to ensure the mouth of the tick does not remain attached to the skin.

To make matters difficult, ticks are very small spider-like creatures and their bites are not painful, so you may not even realise you have one attached to your skin. Not all ticks carry the bacteria that cause Lyme disease, so being bitten doesn't mean you'll definitely be infected.

Common sense measures apply: keep to footpaths and avoid walking in long grass, wearing long-sleeved shirts and trousers in tick-infested areas and use insect repellent on exposed skin. Inspect your skin for ticks at the end of the day, including your head, neck, scalp and skin folds. Try to ensure ticks are not brought home on your clothes, picnic blankets or on your pets fur.

Diagnosis can also be tricky, even at the very early stages when it can be localised, or subsequently, when it becomes disseminated (spread around the body).

About 80pc of infected individuals develop a typical rash that looks like the bulls-eye on a dartboard surrounding the bite mark. Nevertheless, only about a quarter of individuals recall being bitten. The distinctive circular rash typically appears between 3-30 days after a bite.

Lyme disease is known as a great imitator as it can present with your typical flu-like symptoms, including fever, fatigue, muscle or joint pain, headaches or even neck stiffness.

After several weeks to months, the early disseminated features of the disease present. These typically involve the heart and neurological system complications, including meningitis. If diagnosed at this stage, the disease can still be treated with antibiotics for a longer duration.

Late Lyme disease can develop up to several months or even years after the initial infection, with the major manifestation being arthritis, typically involving the knee joint or other large joints in a migratory (going from one large joint to another) fashion. Other features include neurological symptoms, heart or eye problems.

Unfortunately, treatment at this late stage does not always guarantee an improvement in your symptoms.

My best advice is to be aware, take precautions and look and listen to your children. However, be cognisant that this not a common disease with approximately 100 cases in Ireland each year, so don't let it make you too anxious!

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